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Issue Number 40            December 30, 1998


  1. OPV is no longer recommended for the first two doses of the polio series, except in special circumstances
  2. CDC satellite broadcast, "Preparing for the Next Influenza Pandemic," to air on February 25
  3. MMWR publishes article on influenza vaccination status of persons aged 65-79
  4. Editors' reminder: Free influenza teaching module available
  5. Conference on vaccine research set for March 28-30


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December 30, 1998

OPV is no longer recommended for the first two doses of the polio series, except in special circumstances such as a child whose parents do not accept the recommended number of injections, or a child who will be traveling to a polio-endemic area. This recommendation was made by the Advisory Committee on Immunization Practices (ACIP) at its October 21-22, 1998, meeting. The ACIP voted to continue recommending that the first two doses of polio vaccine should be IPV at 2 and 4 months of age, followed by a dose of OPV at 12-18 months and another dose of OPV at 4-6 years of age. Use of IPV for all doses is also acceptable.

An article on the ACIP's changes in the polio vaccination schedule, which appeared in the November 26, 1998, issue of CDC's National Immunization Program's "Polio Vaccine UPDATE," stated that implementation of this recommendation will begin January 1, 1999, with release of the Recommended Childhood Immunization Schedule. The entire article is reprinted as follows:

"The Advisory Committee on Immunization Practices (ACIP) voted to recommend a change in the polio vaccination schedule during its meeting held in Atlanta, Georgia, October 21-22, 1998. The ACIP voted to continue recommending that the first two doses of polio vaccine should be IPV at 2 and 4 months of age, followed by two doses of OPV at 12-18 months and 4-6 years of age. Use of IPV for all doses is also acceptable.

"The change from the 1997 ACIP recommendation is that OPV is no longer recommended for the first two doses except in special circumstances, such as a child whose parents do not accept the recommended number of injections, or a child who will be traveling to a polio-endemic area.

"OPV continues to be recommended as the most effective vaccine for mass immunization campaigns to control outbreaks due to wild polio virus. IPV is the only poliovirus vaccine recommended for children who are immunocompromised, who have close contact with immunocompromised persons, or who have an increased risk of developing polio.

"Implementation of the recommendation will begin January 1, 1999, with release of the revised Recommended Childhood Immunization Schedule. A revised Vaccine Information Statement will be provided to states for distribution in the near future.

"The recommendation was made to address continued concerns related to VAPP and OPV. There were four confirmed cases of VAPP reported during 1997-98, all associated with the first or second dose of an all-OPV schedule. Three suspected cases of VAPP are being investigated. There has been no confirmed VAPP reported with the sequential schedule. Expanded use of IPV has not been associated with increased risk or unexpected adverse events, according to data from the Vaccine Adverse Events Reporting System (VAERS).

"The ACIP also expressed a strong desire to set a date for transition to an all-IPV schedule and will form a working group to consider how such a transition would be implemented. The process would involve working in conjunction with a wider group of partners, including State and local health departments, immunization coalitions, private providers, and national minority and community-based organizations."
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December 30, 1998

On Thursday, February 25, 1999, CDC will present the satellite course, "Preparing for the Next Influenza Pandemic." The course will be broadcast twice, once from 9 a.m. to 11:30 a.m. eastern time and again from 1 p.m. to 3:30 p.m. eastern time.

A brochure announcing the satellite course contains the following sobering message:

"... Epidemiologists agree that the probability is high that another dangerous new strain of the influenza virus will emerge.  In an effort to lessen the worldwide morbidity and mortality that such a strain will cause, public health experts from federal, state and local agencies have developed state and local guidelines to prepare for the next influenza pandemic and its anticipated vaccine shortage and disruption of social and community services."

This live, interactive 2.5 hour broadcast will introduce the guidelines and facilitate state and local emergency response preparation, which can be adapted to other infectious disease crises. The course will be moderated by William L. Atkinson, MD, MPH, medical epidemiologist, National Immunization Program, CDC.  The faculty will include representatives of state and local preparedness programs and guideline developers. For more detailed information about the course, click here:

For information on the availability of this program in your area and to register and order materials, contact your satellite broadcast state coordinator (click here for these phone numbers: ) or call your state immunization program manager (click here for these phone numbers: )
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December 25, 1998

An article entitled "Influenza Vaccination Status of Persons Aged 65-79 Years - Allegheny County, Pennsylvania, February-March 1997" was published in the MMWR on December 25, 1998.

The article summarizes the results of a telephone survey conducted to estimate the prevalence of influenza vaccination, assess barriers to influenza vaccine use in the county, and to evaluate Medicare claims as a measure of vaccination use. The survey was conducted by the Allegheny County Health Department, and the responders were aged 65-79 years of age during February-March 1997.

According to the article the findings from the survey indicate that 75% of the survey responders reported receiving influenza vaccination during the 1996-97 influenza season in comparison with the Medicare claims which indicated that 36% of Allegheny County residents in this age bracket received influenza vaccine.

The article also states that "among the 176 vaccinated participants, the most commonly reported sources of vaccination were physicians' offices (50%), health-care centers (29%), and shopping malls or other locations (21%). Persons of other racial/ethnic groups were more likely than whites to visit personal physicians (62% [95% CI = 45%- 78%] versus 48% [95% CI = 40%-56%]; OR =1.8; [95% CI = 0.8-4.1]) and less likely to go to shopping malls and other public places for vaccination."

The "Editorial Note" makes the following statement concerning the influence of physicians on influenza vaccine use:

"The high proportion of residents reporting physicians as their source of vaccination and the 15% of residents reporting lack of physician's recommendation as a reason for not being vaccinated underscore the influence of physicians on influenza vaccine use.   Academic institutions (e.g., schools of medicine and schools of public health) could provide physician training through continued medical-education sessions that focus on reducing missed opportunities for vaccination and using a patient reminder system. Countywide provider and public educational and promotional campaigns can help dispel concerns about influenza
vaccination and improve acceptance of the vaccine by older adults."

To access the complete article in text format, click here:
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December 30, 1998

The Association of Teachers of Preventive Medicine (ATPM) will send you their teaching module, "Influenza Prevention" for the cost of shipping and handling. This module contains innovative case-based materials that address gaps in knowledge and skills related to vaccine indications, contraindications, and delivery strategies. The materials are based on the most current ACIP recommendations.

If it is your job to teach technical information about influenza to clinicians or clinicians-in-training, you might want to take advantage of this offer. For more information about these materials or other resources that are available from ATPM, call 800-789-6737 between the hours of 9 a.m. and 5 p.m. eastern time.
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December 25, 1998

Information on the Second Annual Conference on Vaccine Research, which is set for March 28-30, 1999, was published as a "Notice to Readers" in the December 25, 1998, MMWR. The entire notice reads as follows:

"The Second Annual Conference on Vaccine Research: Basic Science-Product Development-Clinical and Field Studies will be held March 28-30, 1999, in Bethesda, Maryland. Cosponsors are CDC, the National Foundation for Infectious Diseases (NFID), the National Institute of Allergy and Infectious Diseases, the Center for Biologics Evaluation and Research of the Food and Drug Administration, the World Health Organization, the Children's Vaccine Initiative, the International Society for Vaccines, and the Albert B. Sabin Vaccine Institute. This conference will feature scientific data from the diverse disciplines involved in the research and development of vaccines and associated technologies for disease control through vaccination. Additional information about program announcements, registration, and
abstract submission is available from NFID, Attention: Mr. Kip Kantelo, Suite 750, 4733 Bethesda Ave., Bethesda, MD 20814-5228; telephone: (301) 656-0003; fax: (301) 907-0878; e-mail:; and from the World-Wide Web site,"

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Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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